The overall goal of this program consists of the development and study of combined heart-lung transplantation and single lung transplantation in patients with advanced disease of the heart and/or lungs for whom ordinary forms of treatment offer no realistic hope of effective rehabilitation. Specific scientific objectives include: 1) definition of appropriate criteria for the selection of recipients most likely to benefit from these forms of transplantation; 2) improvement of methods for donor organ procurement and graft preservation (specifically pulmonary); 3) refinement of techniques of intraoperative management; 4) definition of effective postoperative immunosuppressive regimens and evaluation of new methods for the diagnosis of rejection in heart-lung and lung recipients; 5) prospective evaluation and correlative analysis of the pathology and physiology of heart-lung and lung grafts; 6) investigation of pathological and genetic features specific to patients with cystic fibrosis pulmonary disease; and 7) in vitro study of pathophysiological features and pharmacological responses of pulmonary arterial function in the native lungs of patients undergoing cardiopulmonary or isolated pulmonary transplantation. In addition, this multidisciplinary program in clinical heart-lung and lung transplantation provides in-depth training to medical and surgical trainees and constitutes a demonstration project on national and international levels.